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TUTORIAL REVIEW
Anthony P. F. Turner
Biosensors: sense and sensibility
TUTORIAL REVIEW
Anthony P. F. Turner*
This review is based on the Theophilus Redwood Medal and Award lectures, delivered to Royal Society
of Chemistry meetings in the UK and Ireland in 2012, and presents a personal overview of the field of
biosensors. The biosensors industry is now worth billions of United States dollars, the topic attracts the
attention of national initiatives across the world and tens of thousands of papers have been published
in the area. This plethora of information is condensed into a concise account of the key achievements
DOI: 10.1039/c3cs35528d
to date. The reasons for success are examined, some of the more exciting emerging technologies are
highlighted and the author speculates on the importance of biosensors as a ubiquitous technology of
www.rsc.org/csr
Introduction
Biosensors are analytical devices incorporating a biological
sensing element. They harness the exquisite sensitivity and
specificity of biology in conjunction with physicochemical
transducers to deliver complex bioanalytical measurements
with simple, easy-to-use formats.1 Potential uses embrace
virtually every conceivable analytical task, ranging from medical
diagnostics through drug discovery, food safety, process control
and environmental monitoring, to defence and security applications. The basic concept of the biosensor was first elucidated
by Leyland C. Clark in 1962, in his seminal description of an
Biosensors & Bioelectronics Centre, IFM, Linkoping University, S-58183, Linkoping,
Sweden. E-mail: anthony.turner@liu.se; Web: www.ifm.liu.se/biosensors;
Tel: +46 (0)13 282604
Electronic supplementary information (ESI) available. See DOI: 10.1039/
c3cs35528d
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to a turnover currently in excess of US$13 billion and engaged
the full attention of the worlds major diagnostics companies.1
Hence, electrochemistry has come to dominate distributed
diagnostics, while optical techniques have found their niche
principally in R&D. To complete the picture concerning transduction strategies, advances in acoustic resonance devices are
certainly worthy of note, but both thermometric and magnetic
transduction have failed to have any serious practical impact
to date.
Growth in the field of biosensors has been phenomenal.
When the principal journal in the field, Biosensors and Bioelectronics was launched in 1985 by Elsevier, it published about
thirty biosensor papers that year out of a total published in the
world of approximately one hundred. Last year, there were
about four and a half thousand papers published on biosensors, and this represents more than 10% of all papers ever
published on the subject (Fig. 1). Incidentally, it is interesting
to note that an increasing share of this literature is published
by Asian countries, which now account for approximately
half the papers published on this and closely related subjects.
A diminishing proportion of this work now originates from
Europe, while the output from the USA remains steady. At this
point, an apology is in order, since it is obviously impossible to
do justice to this volume of material, this review will present a
highly personal view of some of the key technology drivers,
applications and potentials of biosensor technology. Despite
the vast numbers of papers published, the field of biosensors may be viewed as comprising essentially two broad
categories of instrumentation: (a) sophisticated, high-throughput
laboratory machines capable of rapid, accurate and convenient
measurement of complex biological interactions and components;
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Fig. 1 Graph of a search on the term biosensor* during the period 1980 to
2011, using the Web of Knowledge.
Bioanity monitoring
The first category of biosensor mentioned above was pioneered
m and his team at Linko
ping University
by Ingemar Lundstro
together with the BIAcoret company, then a spin out from
Pharmacia and now owned by GE. The early history of this
device is excellently presented by the BIAcore engineers in a
contemporary review2 and the essential philosophies of their
design can been seen in subsequent generations of machines
based both on Surface Plasmon Resonance (SPR) and other
detection technologies such as the resonant mirror, diraction
gratings and interferometry. The SPR machines harness a
well-established physical phenomenon exhibited by totally
internally reflected light at an optical interface coated with a
thin layer of metal or semiconductor. The incident resonant
angle at which surface plasmons are excited by plane polarised
light is critically dependent on the Refractive Index at the
interface of the metal (normally gold) layer with a sample.
The addition of an anity element, such as an antibody,
nucleic acid sequence or biological receptor, enables biological
binding interactions to be monitored in real time. The companies producing these instruments have paid considerable
attention to optimising the immobilisation matrix on the
sensing chip, refining the microfluidics and creating userfriendly software. The net result has been a series of highly
successful research machines that have found particular utility
in drug discovery and life science research.3 Some of the
strongest patent protection was routed in the immobilisation
chemistry, using thiol immobilisation of carboxyl groups to
anchor carboxy-methylated dextrans to the surface of the
sensing chip, followed by ethyl(dimethylaminopropyl) carbodiimide (EDC) and N-hydroxysuccinimide (NHS) activation of
the dextran matrix to immobilise the desired ligand. This
endowed the surface with exceptionally high receptor loading
capacity, good biocompatibility and charge eects that helped
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developing with the widespread adoption of localised surface
plasmon resonance (LSPR) based on gold nanoparticles.6
LSPR requires only a light source and a spectrophotometer to
measure the wavelength change in the reflected light from a
nanostructured material or surface. While the penetration
depth of the plasmon field for SPR is between 2001000 nm,
it is 1530 nm for LSPR. Hence bulk eects have less influence.
LSPR is also responsible for the electromagnetic field enhancement that underpins surface-enhanced Raman spectroscopy,
which can identify specific target molecules based on their
unique vibrational signatures. LSP is created when free
electrons on metal nanoparticles are excited by electromagnetic
radiation thus causing polarisation of the charges of the
particle-free conduction electrons. Depending upon number
of free electrons, the dielectric function and dielectric coecient of local medium gives rise to intense optical extinction.
The optical extinction is based on a combination of absorption
and scattering, where absorption depends upon the concentration of particles and scattering is proportional to the square
of the particle concentration. The highest absorption for oscillating dipoles occurs at their resonance frequency, which for
gold nanoparticles, lies in the non-infrared region of the
light spectrum. The exact LSPR spectrum is dependent upon
nanoparticle shape, size, inter-particle distance, dielectric properties and, most importantly, on the dielectric properties of
surrounding medium. This latter property plays the key role in
the development of biological sensors, along with the ability to
tailor the spectral signature of the spectrum by modifying the
shape and size of the nanoparticles. Most frequently, we see
gold nanorods used for these systems, with thiol modification
of the gold surface followed by EDC/NHS immobilisation
chemistry to add antibodies, aptamers or other modified
nucleic acids. Various gold nanostructures have been explored
including nano-rods, nano-rings, nano-crescents and even nanoholes. Some of the most elegant recent plasmonic materials
work has been on angular nanostructures such as cubes and
pyramids, where the slope of the dependence of the LSPR peak
on size, increases as the edges become sharper. Bipyramids
thus yield higher sensitivity anity assays than nanorods and
nanospheres and can be stabilised for biosensing purposes
with the aid of bilayer lipid membranes.
While label-free detection is extremely appealing due to its
inherent simplicity, labels and dyes continue to oer high
sensitivity. Dye label-enhanced SPR, for example, can extend
the capability of a conventional instrument to detect and
quantify the binding of several molecules simultaneously.
Multi-colour analysis at a single wavelength can be used in
genomics for partial sequencing or for proteomic studies.
An elegant single-cell fluorescent approach that is amenable
to decentralised application, using fluorescently-coded microspheres, was very recently published by Fran Liglers group
from the Naval Research Laboratory in Washington.7 They used
a spinning magnetic trap to automate clinical sample processing prior to quantitative pathogen detection with a microflow
cytometer. Another highly novel fluorescent biosensor for the
detection of vimentin serine phosphorylation was recently
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described by Jeong et al.8 They described the use of multicolour
Quenchbodies which depend on the removal of a quenching
eect from the intrinsic tryptophan residues in a carboxytetramethylrhodamine dye attached to the N-terminal region of a
single-chain antibody when antigens bind. Such new work adds
to a wide body of literature describing very sensitive optical
assays, often combined with waveguide devices, to deliver
practical systems for distributed diagnostics and environmental monitoring.
Last, but not least in the label-free anity assay armoury,
come piezoelectric and micromechanical devices. The quartz
crystal microbalance is a well-established tool that correlates
mass changes with frequency of oscillation in air or gases and
monitors complex viscoelastic changes in liquids when a
biological receptor binds its complimentary partner. Instrumental design has been refined to the point that reliable
commercial systems are now available on the market both for
research and for measuring, for example, drugs of abuse and
explosives for border control (e.g. Biosensor Applications,
Solna, Sweden). These machines have capitalised on the experience gained from designing the SPR instruments to oer
advanced microfluidics, friendly user interfaces and easy-touse sample application. Surface acoustic wave devices have also
been used for both gas sensor and biosensor applications,
seeking particularly to take advantage of the higher sensitivity
in liquids oered, in principle, by operating at higher frequencies. The comparative advantages of mechanical biosensors
were recently reviewed by Arlett et al.9 and they highlight the
challenges faced by systems such as oscillating-beam devices
microfabricated in silicon, especially with respect to nonspecific binding. Clever applications that circumvent such
limitations are one expedient, such as measuring antibiotic
activity by following the comparative growth of microorganisms
immobilised on an array of oscillating beams; here, nonspecific binding is no longer a major hurdle since the measurement is comparative. At the extreme end of experimental
elegance using a label-free technique comes a delightful paper
from Silberberg et al. This team was able to functionalise a
200 nm needle with antibodies, insert it into a living cell and
measure the unbinding forces using atomic force microscopy.
This is hardly an example of distributed diagnostics, but does
illustrate how far we have come with biosensors for research
applications. These researchers were able to use their technique to examine the eect of cytoskeleton-disrupting drugs and
to observe eects that were hardly detectable using optical or
fluorescence methods.10
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been an obstruction to patient compliance and various
attempts have been made to reduce the discomfort associated
with taking a blood sample and to improve the transfer of
sample to the machine. A product was briefly oered on the
market by Pelikan Technologies (Palo Alto, USA), which
sampled blood in a near-painless fashion using an electromagnetic sampling system, but it proved too expensive to sell in
sucient numbers. The current state-of-the-art relies on being
able to make measurements on very small blood samples
(13 mL), cam-driven lancets and convenient ergonomics, such
as the co-location of the lancing device. The other important
recent refinement has been the imaginative harnessing of
information technology. This has ranged from the creation of
numerous helpful apps to the integration of glucose sensing
devices with the iPhonet in the form of a plug-in accessory.
Arguably the most imaginative of these ideas was Bayers
DIGITt, which interfaced a glucose meter with a Nintendo
games station to encourage children with diabetes to monitor
their blood sugar by rewarding them with points to obtain
items and unlock new game levels.
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requires the manufacturer to eectively give this meter way as a
loss leader.
So why not print the whole device? All-printed MnZnO
batteries with a capacity of 110 mA h can already be made to
power microsensors and for other applications such as RFID
tags, transdermal drug delivery, cosmetic patches and smart
packaging. These are available as commercial products such as
the SoftBatteryt from Enfucell (Finland). Monochrome emissive or reflective digital displays can be printed on both paper
and plastic, requiring around 13 V for a reflective display and
110 V for an emissive display. A recent report describes a much
simpler way to manufacture active matrix displays that is
particularly suited to this application. Electrochromic display
pixels are printed together with their corresponding organic
electrochemical transistors on opposite sides of a PET substrate, thus both components share a common electrolyte and
conductive polymer.13 Non-volatile and flexible memories
based on ferroelectric polymers oer retention times of more
than 10 years and read/write cycles of 109 and can be mass
produced using roll-to-roll techniques and integrated with logic
elements, sensors, batteries and displays. In keeping with the
trend to interface biosensing systems with telecommunication,
thin film aluminium or copper antennae are also available,
operating in the 1 kHz1 GHz range. All-printed diodes are at
an advanced stage of development and electrochemically and
electrolyte gated OFETs operating at 0.51.5 V oer switch
times of 106 to 102 s. A state-of-the-art combination of these
technologies allows us to formulate an all-printed sensing
instrument where everything is produced on a simple sheet
of PET laminated into a plastic case to form a credit-card like
device. In practice, current printed circuit technologies fall a
little short of requirements and some element of silicon
technology is still required to process the signals, but this
can be reduced to the size of a minute chip barely visible to
the eye. An example of such a working demonstrator is shown
in Fig. 2.
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received well by many people with Type I diabetes (insulindependent diabetes) and others who have diculty managing
their disease, but they are severely technically restricted. The US
Federal Drug Administration (FDA) still requires that a fingerstick blood sample be taken before acting on the result from a
continuous sensor to administer insulin and the technically
exciting possibility of hooking up a continuous sensor to a
commercially-available automated insulin infusion pump is
not permitted. In Europe, some degree of automation has just
recently been approved, allowing the Medtronic device to be
used to shut o insulin if the blood sugar drops too low, thus
avoiding the risk of hypoglycaemia, which is one of the greatest
fears of people with Type I diabetes. These sensors, while
extremely useful, are still not reliable enough; at the heart of
the problem lies the dicultly of implanting an active device in
the body. Perfect biocompatibility has never been achieved and,
at best, implants are tolerated by the body. Add to this, the
requirement to maintain consistent diusion of an analyte
such as glucose across a membrane, while the multifarious
defence mechanisms of the body coat the sensor in proteins and,
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artificial pancreas (a biosensor interfaced to an insulin pump)
redundant.
Emerging technologies
Much has been written about glucose sensors due to their
dominance in the field of biosensors, but this example should
really be viewed largely a model that can be copied for hundreds
and potentially thousands of alternative analytes. Admittedly,
GOx has proved a remarkable useful, versatile and robust
enzyme for incorporation into biosensors, but it has been
superseded by alternative, engineered proteins based on quinoprotein glucose dehydrogenase in recent years. A wide range of
other catalysts and anity elements are now available to the
biosensor technologist to create a diverse range of portable and
lab-based instruments using electrochemical, optical or other
transducer technologies. Genetic manipulation of catalytic
proteins has created hybrid enzymes combining the best redox
centres with protein shells exhibiting the greatest anity and
specificity for the desired metabolite. Meanwhile, the art of
stabilisation has improved, using polyelectrolytes and sugars to
stabilise dry reagents and yield long, stable shelf lives.
While electrochemical biosensors have made most impact
in the form of enzyme electrodes, electrochemical immunoassay has delivered some remarkable results and a few minor
commercial products. Once the initial concept of using an
enzyme label had been established, workers began to experiment with various biochemical amplification schemes. By
increasing incubation times and reducing volumes, very low
concentrations of analyte could be recorded in the femtomolar
and even attomolar range. These and other label-based techniques lend themselves to incorporation into the lateral-flow
formats that have been so successfully realised for pregnancy
test strips. Commercial applications in this area were severely
curtailed for 20 years due to the aggressive position taken by
the original patent owners, but now that these have expired, we
see numerous systems being launched with electrochemical,
optical and even magnetic transducers, although the later has
failed to live up to its exciting early promise. A second important electrochemical immunoassay technology exploited the
Field Eect Transistor (FET) by monitoring the charge eects
resulting from biochemical interactions at the gate of the
transistor. This original work in the late 1970s and early 80s
has undergone something of a revival, stimulated by the recent
availability of nanomaterials exhibiting extraordinary electronic
properties such as the nanowire, enabling highly sensitive
detection of bioanity interactions.15,16
The mainstay anity element, the antibody, has likewise
been modified to reduce excess baggage (antibody fragments)
and improve selectivity (monoclonal antibodies). Moreover
alternatives in the form of abodies, peptides, aptamers and
molecularly imprinted polymers have emerged as viable ways to
construct anity sensors. Aptamers, in particular, have attracted
considerable attention since their simultaneous discovery in
1990 by Larry Gold and Jack Szostaks teams and automation
of the technique by Andy Ellingtons lab. While much attention
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is focussed on aptamers as an alternative to antibodies for
therapeutic applications, these randomly selected binding
sequences of nucleic acid also provide a powerful analytical
tool. The now classical process of systematic evolution by
exponential enrichment (SELEX) provides novel binding partners
that can be attached to electrochemical, optical, piezoelectric or
other micromechanical transducers, such as oscillating beam
structures, to provide a new range of versatile anity sensors.
These chemically synthesised receptors can be readily modified
with a tail for immobilisation to gold or carbon surfaces and
can display conformational changes which can be harnessed in
the transduction process. They are particularly useful when
good antibodies are scarce or dicult to produce, such as in
the case of detecting toxins. Although now widely used to make
material for both medical and environmental sensors, the
SELEX process itself is less than perfect for the purpose.
Due to volume constraints, SELEX routinely only searches
about 1014 of a possible 1018 2060 mers. In addition, nonspecific recognition of the support may occur and the
polymerase chain reaction used in the process tends not to
amplify secondary structures. In order to help improve the
design of aptamers, we recently reported a retrospective
computational docking study of the thrombin aptamer (TBA)
5 0 -GGTTGGTGTGGTTGG-3 0 .17 TBA interacts specifically with
the fibrinogen recognition exosite through the two TT loops.
We used this computational approach to confirm the results
observed in SELEX as a first step in reducing the number of
structures screened in the first pool of potential binding agents.
In this way, we hope to both reduce the time taken to find an
appropriate aptamer and increase the chances of finding the
best possible sequence.
Another non-immunoglobulin protein that can be used in
sensors is the abody, based for example, on the immunoglobulin binding B domain of protein A from the bacteria
Staphylococcus aureus. Genetic engineering of this region
results in an analogue known as the Z domain, further modification of which, via mutagenesis, leads to the production of a
range of high anity molecules that can be used as alternatives
to antibodies18 in anity sensors and assays. For example, we
have obtained promising results using such abodies to detect
the overexpression of human epidermal growth factor receptor
2 (HER2), which is observed in 2030% of breast cancer cases.
Such semi-synthetic receptors may also be used in combination
to create hybrid sensors where the initial capture molecule
maybe, for example an aptamer, but a second recognition
element such as an enzyme-labelled monoclonal antibody is
used in a sandwich format to enhance the specificity and
sensitivity of detection. Such combinations can also be combined with magnetic beads to aid separation from complex
media such as blood, milk or turbid environmental samples.
Progressing from semi-synthetic to fully synthetic analogues
of biological receptors could furnish a new generation of
sensors that display the desired sensitivity and specificity of
biosensors, but lack their consequential instability and, in some
instances, irreproducibility. A variety of synthetic receptors have
been explored for this purpose, but one of the most promising
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in the literature in recent years, but to the authors knowledge,
no molecularly-imprinted sensors are yet on the market,
although one company in the UK is known to have developed
and manufactured in quantity a sensor for the anaesthetic gas,
Propofol.
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as multi-labels for anity reactions, with each being separately
detected via the electrochemistry of its ion. Finally, and arguably most elegantly, molecular-beacon architectures can be
exploited to monitor conformational changes occurring upon
binding of, for example, an aptamer to its target. In this design,
a redox species such as a ferrocene, is anchored to the tail of the
aptamer, while the other end of the nucleic acid sequence
is tied to an electrode surface. Conformational changes on
binding are recoded by virtue of the proximity of the redox
species to the electrochemical surface, eectively switching the
signal on or o as the aptamer binds. The detection of
structure-responsive recognition elements such as electrochemical molecular beacons and apta-beacons can be further
enhanced by nano-structuring the receptor surface to improve
receptor loading and signal strength. Nano-porous gold
surfaces, for example, can be prepared by de-alloying of goldsacrificial metal alloys to facilitate high rates of catalysis and
high immobilisation densities.
Most recently, nanostructured materials have been used
to deliver label-free electrochemical immunoassays. Justin
Goodings group in Australia described a direct electrochemical
immunosensor for detection of veterinary drug residues in
undiluted milk. They used a displacement assay for with a
mixed layer of oligo(phenylethynylene) molecular wire, to facilitate electrochemical communication, and oligo(ethylene
glycol) to control the interaction of proteins and electroactive
interferences with the electrode surface.28 More recently, we
reported on the use of a highly conductive N-doped graphene
sheet-modified electrode, which exhibited significantly increased
electron transfer and sensitivity towards the breast cancer marker
CA 15-3. This label-free immunosensor delivered a low detection
limit of 0.012 U mL1 and worked well over a broad linear range
of 0.120 U mL1.29
The other obvious target for electrochemical anity sensors
is DNA. The advent of the DNA chip has focused attention
on alternatives to the fluorescence detection made famous in
the Aymetrixt system. Several companies have successfully
launched electrochemical arrays and the literature abounds
with various electrochemical detection schemes. Many of the
electrochemical DNA sensors reported have targeted the detection of single nucleotide polymorphisms (SNPs) associated with
inherited diseases or short pieces of DNA associated with
specific organisms. The idea of using a redox label attached
to a complimentary strand of nucleic acid to render it electrochemically active on binding its partner or on displacement, is
now well established. However, an interesting idea to enhance
the sensitivity and specificity of such detection has recently
been published and serves to illustrate a general and important
principle. Nasef et al. described melting-curve analysis of
ferrocene-functionalised DNA bound to its complimentary
strand directly on an electrode, by following the electrochemistry of the redox tag with change in temperature.30 This
electrochemical method enhanced by temperature modulation,
illustrates how a second level of analysis can not only yield
additional information, but can greatly enhance the quality of
information from the initial sensor response. Such a strategy is
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that threatens to spiral out of control. According to the WHO,
the USA already spends 17.9% of its GDP on healthcare, while
the European Union average is closer to 9.5% (UK and Sweden
9.6%). Technology needs to oer more economic solutions and
distributed diagnostics enabled by biosensors and enhanced by
consumer products available over-the-counter are a key part of
the solution. This is also commercially attractive, with in vitro
diagnostics already worth an estimated US$40 billion per year.
While glucose biosensors for diabetes have had the most
profound eect on disease management to date, biosensors for
other metabolites promise utility for other non-communicable
diseases such as kidney disease, which is increasingly being
recognised as an emerging problem in a rapidly ageing population. Multifarious anity biosensors have been described to
detect cardiac disease markers such as creatine kinase and
troponin, while cancer markers and single cell cancer detection
have attracted considerable recent literature. Last but by
no means least, nucleic acid-based biosensors such as SNP
detectors and gene chips, have played an increasingly significant role in personalised medicine. The latter area, exploiting
companion diagnostics or theranostics, could oer an estimated world market worth around US$72 billion and encompasses systems combining diagnosis, therapy and monitoring
e.g. a test that qualifies a patient for treatment with a particular
drug. An early example is the HER-2/neu assay (Human
Epidermal growth factor Receptor) required prior to treatment
with Herceptin to determine aggressiveness of breast cancer.
Another example is the predetermination of the presence or
absence of the KRAS genetic mutation, since its presence
results in no benefit from Vectibixt, a monoclonal antibodybased therapy used for colorectal cancer. All this adds up to a
prediction of a strong commercial future for biosensor technology. Fig. 3 shows the value of the biosensor market calculated
from various primary and secondary commercial sources over
the years and predicted for the future.
The principal instrument designs so far delivered for healthcare applications have been pocket-sized portable systems,
desk-top instruments, decentralised analysers and high-throughput,
automated machinery. They range from the home blood
Fig. 3 Graph of the world market for biosensors estimated from various
commercial sources and predicted for the future in US$ millions.
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glucose monitor, through hospital analysers, to automated
drug-screening machines in use by the pharmaceutical companies. When clinical samples are used, they are usually blood
samples obtained either as a pin prick or by a phlebotomist.
As a more patient-focussed approach predominates, however,
new designs for wearable and distributed sensors are emerging.
Implantable sensors are already a reality and used by many
people with diabetes, as described above.
Wearable biosensors present a number of technical challenges
including the availability of a suitable sample that can be readily
accessed without invading the body. Sweat, tears, saliva and breath
has all been intensively explored with limited success. Problems
include lack of correlation with in vivo concentrations, inhomogeneity or variability of the sample and the design of reliable
sampling systems. Saliva, for example, oers potentially reliable
measurements of lactate and salivary amylase, along with an
interesting array of other proteins, but is dicult to access conveniently and reliably, and is easily subject to contamination from
food etc. Incidentally, salivary glucose bears little correlation to
blood glucose, rendering this route ineective for diabetes monitoring and control. Sweat shows a similarly poor correlation,
despite being the target for a number of sensor approaches
reported in the popular press. An arguably more serviceable route
is via the eye using, for example, the contact lens as a sensing
vehicle or mounting optical devices on glasses. Finally, the so far
insurmountable hurdle of comprehensive non-invasive monitoring
continues to attract substantial attention and even more significant
investment. Press reports of solutions continue to abound and
high-profile prizes, promise rich rewards on success. This furore of
public attention can obscure serious research in the field, which is
continuing, since there is no doubt that patients would prefer noninvasive techniques if they could be made to work reliably. Especially challenging is the rapidly increasing demand for technology
to support the elderly. While the top three priorities to improve the
quality of life for people at home are to reduce the risk of falling,
provide orientation aids and counter loneliness, biosensors should
arguably come next as a way to manage chronic multiple sicknesses
and provide early warning of acute problems.
Conclusions
I hope that this brief overview has illustrated that biosensors
have achieved considerable success both in the commercial
and academic arenas and that the need for new, easy-to-use,
home and decentralised diagnostics is greater than ever. The
enormous success of the glucose sensor serves as a model for
future possibilities and should not overshadow the multifarious
other applications that this versatile technology can address.
Theranostics (companion diagnostics) oers an important new
financial model to drive the development of biosensors, since the
principal customer is not the patient, but the pharmaceutical
company seeking to deliver an ecacious therapeutic. Hence,
the dynamic of the normal sales process is shifted towards a
comprehensive set of treatment tools, rather than isolating the
diagnostic device as a separate requirement that has to be
purchased from a separate budget. This could have important
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Acknowledgements
This review is based on a set of lectures presented by the author
to Royal Society of Chemistry meetings in Dublin, Bristol and
London in 2012, following the award of the 2011 RSC Theophilus
Redwood Medal for Analytical Science.
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21 A. Poma, A. Guerreiro, M. Whitcombe, E. Piletska, A. P. F.
Turner and S. Piletsky, Adv. Funct. Mater., 2013, 23, http://
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22 A. Yarman, F. Scheller and A. P. F. Turner, Electropolymers
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23 A. Tiwari, H. Kobayashi and A. P. F. Turner, Biosens.
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